Painkiller shortage hits health service

Doctors were told yesterday to restrict the use of the NHS's frontline painkiller for very sick patients in an attempt to eke out supplies.

The Department of Health said stocks of diamorphine, a drug routinely used for cancer, heart and terminally-ill patients could hit critically-low levels within weeks.

It was urgently seeking extra supplies of alternative drugs to ensure patients did not go without effective pain relief.

The shortages are partly caused by problems at the drug company Chiron's plant in Speke, Merseyside, already responsible for huge flu vaccine shortages.

This second supply failure within three months would be embarrassing for the company, which was unavailable for comment last night, and may also lead to a political row.

Mike Richards, the Department of Health's national cancer director, said: "We have taken immediate action and are working hard to make sure this potential shortfall does not ... impact on the care and quality of life of patients.

"We are in contact with other companies to source extra supplies of morphine and other similar drugs. ... Patients and families should be reassured that we will do all we can to minimise the effect this disruption ... ."

The health department said healthcare professionals should take "every possible step" to conserve stocks of diamorphine injections for use in patients with the greatest need, such as those in palliative care.

Diamorphine is more readily soluble than its alternatives and the average monthly demand in the UK is about 640,000 ampoules of varying strengths. But changing to other drugs would require extreme care to ensure that mistakes are not made over dosages. Patients may be at risk from excessive amounts or left in pain because the alternatives are not as potent.

The Royal College of Surgeons said it was "very concerned and echoed calls to conserve its use.

Diamorphine is made by two companies.

Chiron has told the health department it only has limited supplies and is unlikely to have more before the end of March.

The other manufacturer, Wockhardt UK, also only has limited stocks but hopes to have more by the end of January.

But the government said "the supply situation is likely to remain critical for the immediate future".

Chiron has been banned from making flu vaccine during the northern hemisphere's flu season because of trouble at its Speke plant.

That left an almost 20% shortfall in the UK, causing delays and rearranged appointments for the immunisation programme in several parts of the country while alternative supplies were found.

The problems for the US were far worse. Chiron vaccines should have made up nearly half of the flu jabs there.